Key Concepts and Terms

Key concepts and terms that form the consortium's conceptual foundation may not be familiar to all disciplines, or even to all members of any one discipline, and may often be used without a specific understanding of their definition.   That is a challenge for powerful integration of the many disparate professions represented by consortium members and for the demands of multi-dimensional interventions.  Below are our definitions for key concepts and terms.

Bio-psycho-socio-economic Model

See the full discussion at Bio-Psycho-Socio-Economic Model.

Evidence-based

The core principle of evidence-based practice is that decisions regarding a course of treatment or other action should be based on the best available objective evidence instead of based on tradition, strongly held opinions, personal preference, self-interest, or popular pressure.  The concept of evidence-based practice can apply equally well in managing individual patients and in managing organizations or everyday business operations.

There are some notable differences between the twin concepts of evidence-based medicine and evidence-based management.  Both need to be employed if we want to improve the way that things actually happen every day and overall, not just with a particular individual on a particular day, but consistently within the entire organization, and across whole marketplaces, programs, systems, and jurisdictions.

Evidence-based medicine / healthcare. The healthcare industry produces huge volumes of research in many specialties.  Simply figuring out what the best quality evidence is and what it says is an arduous and time-consuming process – much less figuring out what it implies for action.  All of the existing research studies on a particular topic must be collected, catalogued, and compared.  Someone needs to objectively analyze and compare the technical rigor, freedom from bias, findings, significance, and implications of it all.  Based on their assessment of the current “state of the highest quality evidence,” panels of experts then come up with consensus recommendations, typically published in the form of practice or treatment guidelines.

The effort must be ongoing, since new information is being published every day. The amount of effort required to do a thorough job of this is often beyond practicing clinicians and even major companies. The work has generally been deferred to specialized groups within professional and academic organizations or to new companies that have sprung up to do this work.

Evidence-based management.  The world of business has a shorter history of interest in the scientific method and a less overwhelming volume of research.  Among business people and within organizations, awareness of and enthusiasm for applying scientific research findings to practical business operations is spotty at best — particularly findings about human nature, and especially how individuals and groups make decisions and behave.  Thus, the current mechanism for implementing evidence-based practice is more basic and less cumbersome.  The goal remains: decisions should be based on the best available objective evidence of what works, rather than on tradition, strongly held opinions, personal preference, self-interest, or popular pressure.

Function-focused

Being function-focused means defining the fundamental purpose of health care, benefits programs, and other caring / supporting services as helping people (a) survive and (b) be well and healthy enough to do what they need to do in life and play their roles in society (home, community and work) — even though symptoms of illness or injury may persist and even though some losses do constrain what is possible.

Multi-dimensional Approach

The multidimensional approach refers to a strategy and tactics used to resolve complex problems where biopsychosocial factors are influencing the situation.  Issues in many different domains or dimensions of a person's life may be combining to create difficulties or obstacles, such as healthcare, workplace, benefits, familial, cultural, educational, financial, vocational, emotional, spiritual, philosophical and so on.  Interventions may be needed in any dimension in order for the situation to resolve.  This approach requires collaboration and coordination of effort among a range of helping professionals, which can include employers, benefits administrators, union representatives, attorneys, therapists, counselors, physicians and other health care providers.

Outcomes-focused

Outcomes-focused means keeping the end in mind while making plans and going through processes.  Whenever possible, it means defining the intended outcome at the outset, then documenting and measuring results.  Did anything meaningful actually change because of this intervention?  Was the goal accomplished or not?  Outcomes must be relevant, significant, and replicable.  A sense of perspective is important, here, too.  Some important outcomes are hard to measure, but are more significant than other outcomes which can easily be documented.  A change in a blood pressure reading or the prevailing charge for a medical procedure is simply not as important in the scheme of things as whether someone has a life worth living again.  The Praxis Partners Consortium urges all stakeholders to look up, remember, and at least try to measure “big picture” human outcomes.

Person-centric

Person-centric means remembering and respecting the individual as a whole person, an autonomous decision-maker at the center of a whole human life with its many aspects.  All professionals who provide services need to keep this perspective.  Services and supports should be designed to fit the needs of the person in their specific context.  For example, health care decisions should be made in conjunction with the affected person, taking into consideration that person's values and preferences, since they will feel the impact most acutely and live with all of the consequences.

Prevention-oriented

The US healthcare delivery system is currently set up best to treat and manage acute illness and injury.  However, the majority of the current healthcare budget is being consumed on care of chronic illness and impairment that was mostly preventable.  Today, the smallest amount of funding and services are available for services that increase wellness and nip early health problems in the bud.  A prevention-oriented approach reverses these priorities and increases the time, attention, and resources devoted to upstream opportunities to prevent ill-health and related impairment and work disability.